Microsurgical Resection of a Cavernous malformation of the trochlear nerve - a case-report

Background: Cavernous malformations (CMs) involving cranial nerves are exceedingly rare. To date, only six cases of trochlear nerve involvement have been published in the literature. We present the case of a microsurgical resection of a CM affecting the trochlear nerve. Methods: We report the clinical case of a 32-year-old patient who developed diplopia due to a CM affecting the trochlear nerve. Magnetic resonance imaging showed a contrast-lesion measuring 9 × 5 mm affecting the trochlear nerve. Microsurgical resection of the lesion via a subtemporal approach under continuous neuromonitoring was performed. Results: The patient underwent successful microsurgical resection. Postoperatively, the patient’s diplopia remained unchanged. No new neurological deficits were observed. Conclusion: This case demonstrates the feasibility and safety of microsurgical resection of a trochlear nerve CM. Given the rarity of this entity, individual case reports contribute valuable insight into diagnosis and surgical management.